SHTM 2027 Part 1 Ver2 - HFS Part 1 Ver2.pdfMemorandum 2027 (Part 1 of 4) Overview and management responsibilities Hot and cold water supply, storage and mains services NHSScotland,

Scottish Health TechnicalMemorandum 2027

(Part 1 of 4)

Overview and management responsibilities

Hot and cold water supply, storageand mains services

NHSScotland, P&EFEx, June 2001

Disclaimer

The contents of this document are provided by way of guidance only. Any party making anyuse thereof or placing any reliance thereon shall do so only upon exercise of that party’sown judgement as to the adequacy of the contents in the particular circumstances of itsuse and application. No warranty is given as to the accuracy of the contents and theProperty and Environment Forum Executive, which produced this document on behalf ofNHSScotland Property and Environment Forum, will have no responsibility for any errors inor omissions therefrom.

The production of this document was jointly funded by the Scottish Executive HealthDepartment and the NHSScotland Property and Environment Forum.

ARCHIVE

SHTM 2027 (Pt 1): Hot and cold water supply, storage and mains services

Version 2.0: June 2001 Page 2 of 30© Borders General Hospital NHS Trust on behalf of

NHSScotland Property and Environment Forum

Contents

1. Introduction page 41.8 Definitions

2. Management responsibility page 62.1 Management accountability2.6 Statutory requirements2.8 Health and Safety at Work etc Act2.10 The Management of Health and Safety at Work Regulations 19992.11 Control of Substances Hazardous to Health (COSHH) Regulations

19992.12 Public Health (Infectious Diseases) (Scotland) Regulations 19752.13 Water Supply (Water quality) (Scotland) Regulations19902.15 Food Safety Act 19902.16 Approved Code of Practice2.20 Model Water Byelaws2.22 Building Regulations 2.23 Building Services Research and Information Association2.24 British Standards2.26 Operational management2.29 Designated staff functions

2.29 Management2.31 Infection control officer2.33 Nominated person2.37 Maintenance technician2.38 Tradesperson2.39 Installer2.40 Contractor2.41 Contract supervising officer

2.42 Record keeping2.43 Water economy and energy management

3. Description of systems page 133.2 Sources of supply3.7 Water treatment3.9 Water storage3.16 Cold water distribution system3.18 Hot water storage and distribution3.25 Materials of construction3.26 Validation and verification3.30 Operational management

ARCHIVE




4. Management summary page 204.1 General4.6 Water management4.7 Energy management4.8 Maintenance4.11 Maintenance responsibility4.12 Contract maintenance4.13 Maintenance brief4.15 Performance monitoring

References page 24

ARCHIVE




1. Introduction

1.1 Scottish Health Technical Memorandum 2027; Hot and cold water supply,storage and mains services, is published in four separate parts. It is equallyapplicable to both new and existing sites and gives comprehensive adviceand guidance to healthcare management, design engineers, estatemanagers and operations’ managers on the legal requirements, designapplications, maintenance and operation of hot and cold water supply,storage and distribution systems in all types of healthcare premises.

1.2 Current statutory legislation requires both “management” and “staff” to beaware of their individual and collective responsibility for the provision of hotand cold water supplies, storage and distribution in healthcare premises.

1.3 Healthcare premises are dependent upon water to maintain a safe andcomfortable environment for patients and staff, and for treatment at all levelsof clinical and surgical care.

1.4 The development, construction, installation and maintenance of hot and coldwater supply systems are vital for public health. Water quality is influencedby political, environmental and technical issues. It is governed by legislation,water byelaws, building regulations, approved codes of practice andtechnical standards intended to safeguard quality.

1.5 Interruptions in water supply can disrupt healthcare activities. The design ofsystems must ensure that sufficient reserve water storage is available tominimise the consequence of disruption, while at the same time ensuring anadequate turnover of water to prevent stagnation in storage vessels.

1.6 While some guidance on the water services applications mentioned below isgiven in this memorandum, reference should be made to:

laundry – see Health Building Note 25; Health Building Note is suitable foruse in Scotland subject to the amendments contained in the ManagementExecutive Letter MEL 94/108

sterile supply departments – see Health Building Note 13; ScottishHospital Planning Note 13 issued with MEL 94/63

hydrotherapy pools – see Public Health Laboratory service booklet,Hygiene for Hydrotherapy Pools.

SHTM 2040; The control of legionellae in healthcare premises – a code ofpractice should be consulted for guidance on the prevention of legionnaires’disease.

ARCHIVE




Definitions

1.8 Definitions of terms are as those contained in BS 6100 Sections 2.7 and 3.3,BS 6700 and Model Water Byelaws.

ARCHIVE




2. Management responsibility

Management accountability

2.1 Management has the overall responsibility for implementing procedures toensure that reliable hot and cold water supply, storage and distributionsystems operate within the organisation.

2.2 These procedures should demonstrate that any person on whom thestatutory duty falls has fully appreciated the requirement to provide anadequate supply of hot and cold water of suitable quality. Thoughcompliance with this guidance may be delegated to staff, or undertaken bycontract, accountability cannot be delegated.

2.3 Regular assessments should be made at least annually, using this guidance,to establish the extent of the risk. Shortfalls should be clearly recorded andthe proposed control measures, with timescales, developed. A review shouldbe undertaken whenever there is a substantial change in physical orenvironmental conditions.

2.4 The objective must be to institute management procedures to ensure thatcompliance is continuing and not notional. The prime purpose of theassessment is to be able to demonstrate that management has identified allthe relevant factors, has instituted corrective or preventive action and ismonitoring the plans being implemented.

2.5 This guidance should be applied to all healthcare premises, however small,where there is a duty of care under the Health and Safety at Work etc Act1974.

Statutory requirements

2.6 It is the responsibility of management to ensure that their premises complywith all statutes.

2.7 Management (owners or occupiers) of healthcare premises have anoverriding general duty of care under the Health and Safety at Work etc Act1974. Therefore, they should ensure that the water supply, storage anddistribution services can be provided within the terms of the followinglegislation.

ARCHIVE




Health and Safety at Work etc Act 1974

2.8 Employers have a general duty, under the Health and Safety at Work etc Act1974 to ensure, so far as is reasonably practicable, the health, safety andwelfare of their patients, employees and visitors who may be affected byworkplace activities.

2.9 These duties are legally enforceable and the Health and Safety Executivehave successfully prosecuted employers including Health Authorities andTrusts under this statute. It falls upon owners and occupiers of premises toensure that there is a management regime for the proper design, installationand maintenance of plant, equipment and systems. Failure to have a propersystem of work and adequate control measures can also be an offence eventhough an outbreak of, for example, legionnaires’ disease or other suchincident has not occurred.

The Management of Health and Safety at Work Regulations1999

2.10 These regulations require every employer to make a suitable and sufficientassessment of all risks to health and safety of employees and the publiccaused by work activities. In addition to legionella, other risks from a hot andcold water distribution system include deterioration of water quality, scaldingat hot water outlets and danger due to bursting at excessive pressures.

Control of Substances Hazardous to Health (COSHH)Regulations 1999

2.11 In the context of hot and cold water supply, storage and mains services,these regulations apply to micro-organisms, such as legionellae and to thechemicals which may be used to control the growth of micro-organisms inwater supply. Employers have a duty to assess the risks from exposure tothese substances to ensure that they are adequately controlled.

Public Health (Infectious Diseases) (Scotland) Regulations1975

2.12 These regulations require that a properly appointed officer shall inform thechief medical officer, of any serious outbreak of any disease which to hisknowledge has occurred.

For further reference refer to: Public Health (Notification of InfectiousDiseases) (Scotland) Regulations 1988, Public Health (Notification ofInfectious Diseases) (Scotland) Amendment Regulations 1989. The ScottishOffice, Department of Health, Advisory Group on Infection, Scottish Infection

ARCHIVE




Manual. Guidance on core standards for the control of infection in hospitals ,healthcare premises and at the community interface (1998).

Water Supply Regulations2.13 The Water Supply (Water Quality) (Scotland) Regulations 1990 (as

amended), apply to water supplied to any hospital which is used fordomestic purposes such as drinking, washing or cooking. Two additionalsources of advice on drinking water quality are:

a. the Director of Public Health;b. the World Health Organisation ‘Guidelines for drinking water quality’

1993.

2.14 The Private Water Supplies (Scotland) Regulations 1992 (StatutoryInstrument 1992/574) cover private water supplies such as boreholes andwells.

Food Safety Act 1990

2.15 The Food Safety Act 1990 covers water used for food preparation or foodmanufacture and also includes water used for drinking. Food Safety(Temperature Control) Regulations 1995 will also apply as will the FoodSafety (General Food Hygiene) Regulations 1995.

Approved Code of Practice

2.16 The Health and Safety Commission have published an, ‘Approved Code ofPractice (ACOP)’ and the Health and Safety Executive have produced aguidance note (HS(G)70) entitled, ‘The control of legionellosis includinglegionnaires’ disease’. The onus is on management to demonstrate thatprocedures in place are as good as, or better than, those required by theACOP.

2.17 Compliance with the guidance given in SHTM 2040 will satisfy the ACOPrequirements for the control of legionellosis.

2.18 The health service, with responsibility for the wider aspects of public healthand the operation of NHS in Scotland premises, is expected to beparticularly vigilant. The number of outbreaks of legionnaires’ disease isrelatively small, but outbreaks are considered to be avoidable. Managementmust also acknowledge that incidents or outbreaks cause widespreadconcern, especially if associated with healthcare premises. Investigation ofthese outbreaks has shown that they are generally related to a breakdown inmanagement systems. Design flaws and defects have also been implicatedas the cause of some outbreaks.

ARCHIVE




2.19 Hence, managers need to satisfy themselves by monitoring, that effectivecontrol procedures are being implemented. It is not sufficient merely todevise procedures.

Model Water Byelaws

2.20 All water authorities responsible for water supply have a statutory duty toenforce their byelaws for the prevention of waste, undue consumption,misuse and contamination of water supplied by them.

2.21 In 1989 new model water byelaws came into effect and these are set out,along with the water industry’s interpretation of these provisions, in the‘Water Supply Byelaws Guide 1989’. The WRc (Water Research Centre)operates the Evaluation and Testing Centre which provides advice onbyelaws on a national basis and administers the Water Byelaws Schemewhich tests and lists water fittings and materials for compliance with thebyelaws. The ‘Water Fittings and Materials Directory’ contains informationon suitable fittings and materials and is updated every six months.

Building Regulations

2.22 Part P of Schedule 1 of the Building Standards (Scotland) Regulations 1990provides the functional requirements for the unvented hot water storagesystems.

Building Services Research and Information Association

2.23 Application Guide AG4/94 Guide to legionellosis - temperaturemeasurements for hot and cold water services. A practical guide which setsout the main activities which are essential for compliance with the HS(G)70guidance on water temperatures. Its principle on planning, measurementand site procedure are equally applicable to healthcare premises.

British Standards

2.24 BS 6700: 1997 is the British Standard specification for design, installation,testing and maintenance of services supplying water for domestic use withinbuildings and their curtilages.

2.25 BS 1710: 1984 is the British Standard specification for identification ofpipelines and services.

ARCHIVE




Operational management

2.26 Managers should ensure that an operational plan is in place for each siteunder their control. This document should comprise:

a. up-to-date drawings and descriptions of all the supply storage anddistribution systems within those premises;

b. step-by-step instructions to operate, maintain, control and shut down thewater supply, storage and distribution systems within those premises;

c. a schedule of possible emergency incidents causing loss of the watersupply from the water authority. Each item in the emergency incidentschedule should include guidance on operational procedures to re-establish a stable wholesome water supply. In re-establishing the watersupply, input from the infection control team and the Consultant inCommunicable Disease Control may be required.

2.27 A routine of staff training should be implemented by management on thesystems’ basic operational procedures, and also on those systemprocedures required during an emergency.

2.28 Only properly trained nominated persons should be appointed bymanagement to control the operation of emergency equipment.

Designated staff functions

Management

2.29 Management is defined as the owner, occupier, employer, general manager,chief executive or other person who is ultimately accountable for the safeoperation of healthcare premises.

2.30 A person intending to fulfil any of the staff functions specified below shouldbe able to prove that they possess sufficient skills, knowledge andexperience so as to be able to perform safely the designated tasks.

Infection control officer

2.31 Infection control officer-or consultant microbiologist, if not the same person,nominated by the management to advise on monitoring infection controlpolicy and for the maintenance of water quality.

Nominated person

2.33 A nominated person (water), possessing adequate professional knowledgeand with appropriate training, should be nominated in writing bymanagement to devise and manage the necessary procedures to ensurethat the quality of water in healthcare premises is maintained. The personwill be required to liase closely with other professionals in various disciplines.

ARCHIVE




In addition, the person should possess a thorough knowledge of the controlof legionellae and would ideally be a chartered engineer.

2.34 This person’s role, in association with the infection control officer andmaintenance staff, involves:

a. advising on the potential areas of risk and identifying where systems donot comply with this guidance;

b. liaising with the water authorities and environmental health departmentsand advising on the continuing procedures necessary to ensureacceptable water quality;

c. monitoring the implementation and efficacy of those procedures;d. approving and identifying any changes to those procedures;e. ensuring that equipment which is to be permanently connected to the

water supply is properly installed;f. ensuring that adequate operating and maintenance instructions exist

and adequate records are kept.

2.35 Implementation of an effective maintenance policy must incorporate thepreparation of fully detailed operating and maintenance documentation andthe introduction of a logbook system. The “nominated person” shouldappoint a deputy to whom delegated responsibilities may be given. Thedeputy should act for the nominated person on all occasions when thenominated person is unavailable.

2.36 The nominated person should be fully conversant with the design principlesand requirements of water systems and should be fully briefed in respect ofthe cause and effect of water-borne organisms, for example Legionellapneumophila. The appointment of an engineer as the nominated person isappropriate in that the responsibility can extend to the operation andmaintenance of associated plant. It is recognised that the nominated personcannot be a specialist on all matters and must be supported by specialists inspecific subjects such as water treatment and microbiology, but he/she mustundertake responsibility for calling upon and co-ordinating the activities ofsuch specialists.

Maintenance technician

2.37 A person who, in the opinion of the nominated person, has sufficienttechnical knowledge and the experience necessary to carry out maintenanceand routine testing of the water, storage and distribution system.

Tradesperson

2.38 A person who is appointed in writing by the nominated person to carry out,under the control of the maintenance technician, work on the water, storageand distribution system.

ARCHIVE




Installer

2.39 A person or organisation responsible for the provision of the water, storageand distribution system.

Contractor

2.40 The person or organisation designated by management to be responsible forthe supply and installation of hot and cold water services, and for theconduct of the installation checks and tests.

Contract supervising officer

2.41 The person authorised by the hospital management to witness tests andchecks under the terms of contract. He/she should have specialistknowledge, training and experience of hot and cold water supply, storageand mains services and SHTM 2027.

Record keeping

2.42 Management should ensure that an accurate record of all assets relating tothe hot and cold water distribution systems is set up and regularlymaintained. They must also ensure that records of all maintenance,inspection and testing activities are kept up-to-date and properly stored.

Water economy and energy management2.43 Managers should ensure that water economy and energy management

policies are set up and adhered to. The requirements of such policies arebriefly outlined in Chapter 4.

ARCHIVE




3. Description of systems

3.1 The following sections give a brief description of hot and cold water systems.

Source of supply

3.2 Normally, the source of water supply to a health building is by one or moreservice pipe connections from the mains of a water authority. If the quantityand rate of flow is inadequate, or if the cost of providing the serviceconnection appears to be uneconomical, alternative sources of supply suchas boreholes or wells may be investigated.

3.3 The feasibility of a private supply should be decided by comparing thecapital and revenue costs with the long-term cost of water supplied from thestatutory authority. Due consideration should be given to the long-term costsof a private supply and account should be taken of potential deterioration inwater quality and/or capacity of the private supply source.

3.4 Provision should be included for alternative water supply arrangements tomeet an emergency, regardless of the source or sources of supply finallyadopted. Alternative arrangements would include the provision of a secondservice connection from the statutory water authority or a private supply. Thewater quality requirements applicable to the main supply apply also to anyalternative supplies.

3.5 Physical interconnection of pipework and valves of a statutory waterauthority’s supply with any private supply is normally prohibited by waterbyelaws in order to eliminate backflow from one supply into the other. Thestatutory water authority should be advised of the NHS need to use anyprivate supply as well as the statutory water authority’s supply, and adviceshould be sought on the limitations imposed in respect of break cisterns andinterconnection thereafter.

3.6 All water intended for human consumption is required by legislation tocomply with the quality standards laid down in the Water Supply (WaterQuality) Scotland Regulations 1990. These regulations apply to watersampled at the point where the water is available for use and embrace notjust drinking water but also water used for domestic purposes.

Water treatment

3.7 While potability is not normally affected by such characteristics as hardness,colour, and (within limits) smell and/or taste, a measure of treatment may benecessary to provide a more acceptable supply, for example to protectequipment from deterioration.

ARCHIVE




3.8 Treatment may also be considered necessary where the water is to be usedin humidification plant, steam boilers, laundries or other heating processes.

Water storage

3.9 Water is stored in large developments like health buildings for three basicreasons:

a. to provide reserve supply during failure of the source cold water supplyto the development;

b. to reduce the maximum demand on the cold water main;c. to provide accommodation for displaced cold feed water resulting from

the expansion of any water subjected to heat.

3.10 The purpose for which the storage is used can vary, but this has only aminor effect on design. The range of uses is generally covered by thefollowing:

a. cold water for drinking, washing and cooking;b. cold water feed to hot water services;c. treated cold water for laundries, heating, cooling, etc. when local

supplies are unsuitable;d. supplies to equipment or areas deemed to present a backflow

contamination risk;e. feed and expansion for heating service;f. fire-fighting.

3.11 The water byelaws and BS 6700 specify minimum standards for cold waterstorage cisterns to ensure that the stored water is retained at a potablestandard suitable for domestic use.

3.12 Guidelines on the prevention of legionnaires’ disease (see SHTM 2040)must also be considered in relation to water storage.

3.13 In general terms, water storage should be designed such that stored water isregularly used and not allowed to stagnate. These aims would be realised byensuring that the stored volume is no more than the volume of water usedwithin the building on a daily basis. However, the storage capacity should besized to cover a 12-hour interruption on the assumption that measures willbe taken to minimise water usage during any prolonged disruption.

3.14 In the event of an interruption to the supply, staff should be informed of theneed to economise on water use, so extending the duration of the storedsupply.

ARCHIVE




3.15 Storage cisterns should be located to minimise heat gains. To restrictmicrobiological growth it is important that the temperature of stored water iskept as low as practical, not more than 20°C.

Cold water distribution system

3.16 The design and installation of the cold water distribution system shouldcomply with the water byelaws and BS 6700.

3.17 The design of the pipework should ensure that there is no possibility of across-connection between installations conveying potable water andinstallations containing non-potable water or water supplied from a privatesource. There should be no possibility of backflow towards the source ofsupply from any tank, cistern or appliance, whether by gravity backflow,back-pressure backflow or backsiphonage. A schematic drawing of a hotand cold water services distribution system can be found in Figure 1.

Hot water storage and distribution

3.18 Hot water services should be designed and installed in accordance with thewater byelaws and BS 6700. The hot water system may be of either thevented or the unvented type.

3.19 The components of a hot and cold service system as used within hospitalsare shown in Figure 1; some installations may have fewer, or additional,features or components.

3.20 A vented system usually consists of a cold water storage cistern situatedabove the highest outlets, which feeds a hot water storage vessel (forexample a calorifier or direct-fired boiler).

3.21 An unvented system usually has the hot water storage vessel connected tothe mains water supply via a pressure-reducing valve. The components of adirectly-heated unvented hot water system are shown in Figure 2 .Refer toBS 7206: 1990, ‘Specification for Unvented hot water storage units andpackages’.

3.22 The hot water taken from the top of the storage vessel will be circulatedaround the building in a piped distribution system. The individual outlets,taps, mixing valves or other outlet devices will be served from the distributionsystem.

3.23 Particular attention is drawn to the requirement to incorporate within thedesign, measures to ensure the water is retained in a wholesome condition.Guidance on the control of legionellae in healthcare premises is given inSHTM 2040. In order to ensure that the temperature of the water in thedistribution system is within acceptable limits, a hot water secondarycirculation will be required in which hot water is continuously circulatedbetween the storage vessel and the various outlets. Alternatively, the

ARCHIVE




distribution system may be electrically trace-heated to maintain the requiredtemperature in the pipework.

3.24 Recommendations regarding safe hot water and surface temperatures,given in Scottish Health Guidance Note, ‘Safe hot water and surfacetemperatures’, apply to all ward accommodation, residents’ rooms and thoseareas to which patients, residents and visitors have free access (includingpublic areas). Until the recommended precautions are put into effect, staffshould be made aware of the potential danger and should take thenecessary steps to protect patients, residents and visitors. Areas which donot meet these recommendations should be identified and plans to complyas soon as reasonably practicable should be devised. Reference shouldalso be made to the Model Engineering Specification (MES) DO8Thermostatic Mixing Valves (Healthcare premises).

Materials of construction

3.25 Systems should be in accordance with BS 6700 and BS 6920 and materialsused in hot and cold water distribution should be listed in the latest edition ofthe Water Fittings and Materials Directory, published by the WRc.

ARCHIVE




Figure 1: Schematic Hot and Cold Service Distribution

'A' TYPE AIR GAP

M

M

TUNDISH

DISCHARGE TO WASTE

WARNINGPIPE

COLD WATER TO TAPS

WATER SUB-METERS

COLD FEED PIPE60°C ± 2.5°C

HOT WATER SUPPLY

BASINS

BATH

SHOWERS

DRAIN

SECONDARY CIRCULATION PUMP

NON RETURN VALVE

HOT WATER RETURN > 50°C

DRAIN AT LOWEST POINT

SHUNT PUMP(OPTIONAL)

VENT LID

WATER SUPPLY

WATER STORAGE CISTERN

VENT AND EXPANSION PIPE

SAFETY VALVE

THERMALCUT - OUT

THERMOSTAT

NOTES:

1. ALL PIPEWORK TO BE INSULATED2. ISOLATING AND CONTROL VALVES NOT SHOWN3. ALL DRAINS SHOULD DISCHARGE TO WASTE VIA A TYPE 'A' AIR GAP

ARCHIVE




Figure 2: Directly Heated Unvented System

COLD AND DRINKING WATER

EXPANSIONVESSEL

TEMPERATURE RELIEF VALVE

HOT WATER

EXPANSION VALVEDISTANCE TO BE

KEPT AS SHORT AS POSSIBLE

PRESSURE REDUCING VALVE

STOP VALVE

SAFE AND VISIBLE DISCHARGE VIA TYPE 'A' AIR GAP

WATER SUPPLY MAIN

PACKAGEDBOOSTER

SET(OPTIONAL)

NONRETURN VALVE

THERMAL CUT - OUT

THERMOSTAT

SHUNT PUMP(OPTIONAL)HEAT SUPPLY

HOT WATER SECONDARY RETURN

DRAIN

NON RETURN VALVE: PREVENTS HOT WATER EXPANSION REACHING A BRANCH PIPE SUPPLYING COLD WATER.

EXPANSION VESSEL: ACCOMMODATES EXPANSION WHEN HOT WATER IS HEATED UP FROM COLD

EXPANSION VALVE: DISCHARGES EXPANDED WATER UPON FAILURE OF THE EXPANSION VESSEL.

TEMPERATURE RELIEF VALVE USED AS A BACK-UP IN THE EVENT OF FAILURE OF BOTH THE THERMOSTAT AND THE THERMAL CUT-OFF

THERMAL CUT-OFF CUTS OFF HEAT SOURCE AT A PREDETERMINED MAXIMUM TEMPERATURE.

THERMOSTAT: CONTROLS THE TEMPERATURE OF STORED WATER AT 60°C ± 2°C.

ARCHIVE




Validation and verification

3.26 Pre-commissioning, commissioning and testing are activities that must becarried out once the hot and cold water systems have been installed orrepaired, to ensure that the systems comply with the specification beforehandover.

3.27 Commissioning involves setting a static system into motion and adjusting thesystem so that it operates within specified tolerances.

3.28 Testing involves the checking of pipework, plant, equipment and controls toensure that they operate within specified limits of temperature, pressure etc.

3.29 Further information on this subject can be found in Part 4 ‘Validation andverification’ of this SHTM.

Operational management

3.30 Operating staff need to be provided with the necessary operation andmaintenance manuals and record drawings for any new or refurbished hotand cold water systems, clearly identifying what actions must be carried outto ensure that the system will operate as intended throughout its working life.

3.31 Operation and maintenance manuals should be produced in accordancewith established guidelines.

3.32 Further information on this subject can be found in Part 3 ‘Operationalmanagement’ of this SHTM.

ARCHIVE




4. Management summary

General

4.1 The water supply, storage and distribution service should be periodically re-assessed by management and improved where necessary to ensure that itmaintains an adequate water supply to the healthcare premises facilities.

4.2 Where new healthcare premises are to be built in separate phases, thewater supply, storage and distribution service for the whole premises shouldas far as possible be planned and evaluated at the design stage. This willenable the total water supply requirement to be assessed in the planningstages, and appropriate areas of accommodation to be allocated.

4.3 Within this general guideline, the aim should be to keep water services assimple as practicable.

4.4 Where existing facilities do not meet the standards recommended in thisSHTM, management should carry out a risk assessment which shouldinvolve the infection control team to establish the extent and priority of actionrequired for compliance. Action must then be taken to meet standardsrecommended in this SHTM.

4.5 A procedure of routine checks to ensure a potable and adequate watersupply is recommended in Part 3 ‘Operational management’ of this SHTM.Managers should ensure that tests are done even if they cause minordisruption to hospital services.

Water management

4.6 A water management policy should be set up to define actions which shouldbe taken to ensure that water is used economically and wastage isminimised. Such a policy should include the recommendations of the reportof the Audit Commission for local authorities and the NHS entitled,‘Untapped Savings: Water Services in the NHS’ and NHS Estates, ‘Astrategic guide to water and sewerage policy for general managers and chiefexecutives’.

Energy management

4.7 An energy management policy should be set up to define actions whichshould be taken to minimise energy consumption. An effective maintenanceplan will also contribute to minimising energy consumption. Further guidanceis given in ‘Encode’ and ‘A strategic guide to energy management forgeneral managers and chief executives’.

ARCHIVE




Maintenance

4.8 Management is ultimately responsible for the provision of a wholesomewater supply in the premises under its authority. An effective maintenancepolicy will be instrumental in achieving this end.

4.9 Regulation 6 of the Provision and Use of Work Equipment Regulations 1998requires that every employer shall ensure that work equipment is maintainedin an efficient state, in efficient working order and in good repair. Theemployer’s COSHH assessment should have identified maintenance,examination and control measures to reduce the risk from exposure tohazardous substances. Regulation 9 of COSHH requires those controlmeasures to be implemented.

4.10 Planned maintenance can be divided into two distinct policies:

a. operate plant until failure occurs, where:(i) the consequences of failure will not create a safety hazard;(ii) the consequences of failure will not affect the business operation of

the building occupants;(iii) the costs of repair/replacement are not excessive;(iv) the reaction to failure can be planned in advance;

b. preventative maintenance: this involves a series of inspections at regularintervals and monitoring operating parameters in order to avoid failure byimplementing timely remedial work. Further information on this topic canbe found in Technical Note TN14/92, ‘Decisions in Maintenance’ by theBuilding Services Research and Information Association (BSRIA).

Maintenance responsibility

4.11 Once a maintenance policy has been decided upon, a maintenanceengineer must be given the responsibility for implementing it. Maintenanceresponsibilities include:

a. the provision of adequately trained and supervised manpower;b. clear definitions of the equipment and services to be maintained,

together with the procedures to be carried out on them;c. monitoring of the quality of the work carried out to ensure that it is

consistently acceptable;d. the implementation of financial control procedures.

ARCHIVE




Contract maintenance

4.12 The increasing complexity of building services equipment has resulted in agrowing reliance on contractors for the provision of maintenance services.The decision to use either a contractor or direct labour must be taken in thelight of local circumstances. BSRIA Application Guide 4/89 provides adviceon aspects to be considered when obtaining contract maintenance. Theguidance contained in PROCODE should also be implemented for theappointment of contractors.

Maintenance brief

4.13 The maintenance manager requires a brief from the management which setsout in a clear and unambiguous manner the following requirements:

a. scope of work;b. budgeting – overall and single-item limits;c. level of reliability;d. response time required to correct faults;e. criteria for quality of service;f. reporting procedure;g. accountability and responsibility;h. energy-saving policy;i. health and safety policy.

4.14 The above requirements are necessary regardless of whether the work iscarried out by contractors or in-house staff.

Performance monitoring

4.15 This involves the inspection of systems and records at a frequency, and insuch detail, as to enable management to form an opinion regardingcompliance with the agreed criteria.

4.16 If a contractor is commissioned to carry out maintenance and in-houseexpertise is not available to monitor their performance, an independentprofessional adviser should be retained to carry out this function. Usinganother maintenance contractor in a monitoring role could lead to a conflictof interest. An appropriate consultant may be appointed and referenceshould be made to PROCODE for such an appointment.

ARCHIVE




4.17 A performance monitoring checklist follows:

a. Is the required level of service being met?b. Is all the required plant being maintained?c. Are environmental conditions being maintained?d. Is maintenance carried out to the agreed standard?e. Are proper replacement parts being used?f. Are agreed spares being held on site?g. Are records being correctly maintained?h. Is the maintainer using the agreed standard of staff and number of staff,

and making the agreed number of visits?i. Is the plant being operated to achieve optimum energy usage?j. Are health and safety requirements complied with?k. Are only agreed sub-contractors being employed?l. Are the client and typical users of the building satisfied?m. Where maintenance is on a labour-plus-parts basis do invoices

accurately reflect work carried out?n. Are breakdowns occurring too often?o. Is adequate consideration given to the potential environmental impact of

contractors action, for example, discharge of chlorinated water,discharge of water treatment chemicals either to river or seweragesystems?

ARCHIVE




References

NOTE:Where there is a requirement to address a listed reference, care should be taken to ensurethat all amendments following the date of issue are included.

PublicationID

Title Publisher Date Notes

Acts and Regulations

The Building (Scotland) Act HMSO 1959

Clean Air Act HMSO 1993

Electricity Act HMSO 1989

Food Safety Act HMSO 1990

Health and Safety at Work etc Act HMSO 1974

Registered Establishments (Scotland)Act

HMSO 1998

The Water (Scotland) Act HMSO 1980

Water Resources Act HMSO 1991

SI 2179 &187

The Building Standards (Scotland)Regulations (as amended)

HMSO 1990

The Building Standards (Scotland)Regulations: Technical StandardsGuidance

HMSO 1998

SI 1460 Chemicals (Hazard Information andPackaging for Supply) Regulations(CHIP2)

HMSO 1997

SI 3140 Construction (Design and Management)Regulations

HMSO 1994

SI 437 Control of Substances Hazardous toHealth Regulations (COSHH)

HMSO 1999

SI 635 Electricity at Work Regulations HMSO 1989

SI 1057 Electricity Supply Regulations (asamended)

HMSO 1988(amd1998)

SI 2372 Electromagnetic CompatibilityRegulations (as amended)

HMSO 1992

SI 1763 Food Safety (General Food Hygiene)Regulations

HMSO 1995

SI 2200 Food Safety (Temperature Control)Regulations

HMSO 1995

SI 2451 Gas Safety (Installation and Use)Regulations

HMSO 1998

ARCHIVE




PublicationID


SI 917 Health & Safety (First Aid) Regulations HMSO 1981

SI 682 Health & Safety (Information forEmployees) Regulations

HMSO 1989

SI 2792 Health and Safety (Display ScreenEquipment) Regulations

HMSO 1992

SI 341 Health and Safety (Safety Signs andSignals) Regulations

HMSO 1996

SI 1380 Health and Safety (Training forEmployment) Regulations

HMSO 1990

SI 2307 Lifting Operations and Lifting EquipmentRegulations (LOLER)

HMSO 1998

SI 3242 Management of Health and Safety atWork Regulations

HMSO 1999

SI 2793 Manual Handling OperationsRegulations

HMSO 1992

SI 1790 Noise at Work Regulations HMSO 1989

SI 3139 Personal Protective Equipment (ECDirective) Regulations (as amended)

HMSO 1992

SI 2966 Personal Protective Equipment at Work(PPE) Regulations

HMSO 1992

SI 574 Private Water Supplies (Scotland)Regulations

HMSO 1992

SI 2306 Provision and Use of Work EquipmentRegulations (PUWER)

HMSO 1998

SI 1550 Public Health (Notification of InfectiousDiseases (Scotland) (Amendment))Regulations

HMSO 1989

SI 3163 Reporting of Injuries, Diseases andDangerous Occurrences Regulations(RIDDOR)

HMSO 1995

SI 1333(S129

Water Supply (Water Quality) (Scotland)(Amendment) Regulations

HMSO 1991

SI 119 (S11) Water Supply (Water Quality) (Scotland)Regulations

HMSO 1990

SI 3004 Workplace (Health, Safety and Welfare)Regulations

HMSO 1992

British Standards

BS 864 Capillary and compression tubefittings of copper and copper alloy

BSIStandards

BS 1212 Float operator valvesPart 1: Specification for piston type float operated valves (copper alloy body) (excluding floats)

BSIStandards 1990

ARCHIVE




PublicationID


BS 1710 Specification and identification ofpipelines

BSIStandards

1984(1991)

AMD 61210/85

BS 2486 Treatment of water for steam boilersand water heaters

BSIStandards

1997

BS 3505 Specification for unplasticizedpolyvinyl chloride (PVC-U) pressurepipes for cold potable water

BSIStandards

1986 AMD6130,11/88

BS 3506 Specification for unplasticized PVCpipe industrial uses

BSIStandards

1969 AMD1152,9/73;AMD1777, 7/5

BS 5886 Methods for field pressure testing ofasbestos-cement pipelines

BSIStandards

1980

BS 6100 Glossary of building and civilengineering terms

Section 2.7: Public Health. Environmental Engineering

Section 3.3: Sanitation

BSIStandards

1992

1992

BS 6700 Specification for design, installation,testing and maintenance of servicessupplying water for domestic usewithin buildings and their curtilages

BSIStandards

1997

BS 6920 Suitability of non-metallic productsfor use in contact with water intendedfor human consumption with regardto their effect on the quality of thewater

BSIStandards

BS 7206 Specification for unvented hot waterstorage package and units

BSIStandards

1990

BS 7491 Glass fibre reinforced plastic cisternsfor cold water storage

Part 1: Specification for one-piece cisterns of capacity up to 500L

Part 2: Specification for one-piececisterns of nominal capacity from500L to 25000L

BSIStandards

1991

1992

AMD7382,12/92

BS 7671 The requirements for wiringinstallations (The IEE wiringregulations)

BSIStandards

2001 16th

edition

BS 8007 Code of practice for design ofconcrete structures for retainingaqueous liquids

BSIStandards

1987

ARCHIVE




PublicationID


BS EN 1057 Copper and copper alloys. Seamless,round copper tubes for water and gasin sanitary and heating applications

BSIStandards

1996

CP 312 Code of practice for plasticspipework (thermoplastic material).Parts 1 to 3

BSIStandards

1973

CP 2010-2 Code of practice for pipelines. Designand construction of steel pipelines inland

BSIStandards

1970

Scottish Health Technical Guidance

SHTM 2005 Building management systems P&EFEx 2001 CD-ROM

SHTM 2011 Emergency electrical services P&EFEx 2001 CD-ROM

SHTM 2020 Electrical safety code for low voltagesystems (Escode – LV)

P&EFEx 2001 CD-ROM

SHTM 2023 Access and accommodation forengineering services

P&EFEx 2001 CD-ROM

SHTM 2040 The control of legionellae in healthcarepremises – a code of practice

P&EFEx 2001 CD-ROM

SHGN The Pressure Systems andTransportable Gas ContainersRegulations 1989

P&EFEx 2001 CD-ROM

SHGN ‘Safe’ hot water and surfacetemperatures

P&EFEx 2001 CD-ROM

SHPN 1 Health service building in Scotland HMSO 1991

SHPN 2 Hospital briefing and operational policy HMSO 1993

SHPN 13 Sterile services department HMSO MEL94/63

SHTN 1 Post commissioning documentation forhealth buildings in Scotland

HMSO 1993

SHTN 2 Domestic hot and cold water systems forScottish Health Care Premises

P&EFEx 2001 CD-ROM

SHTN 4 General Purposes Estates andFunctions Model Safety Permit-to-WorkSystems

EEF 1997

Strategic guide to water and seweragepolicy for General Managers and ChiefExecutives

HMSO 1993

ScottishInfectionManual

Guidance on core standards for theinfection of hospitals, healthcarepremises and at the community interface

HMSO 1998

NHS in Scotland – PROCODE P&EFEx 2001 Version1.1

ARCHIVE




PublicationID


NHS in Scotland Firecode

SHTM 81 Fire precautions in new hospitals P&EFEx 1999 CD-ROM

SHTM 82 Alarm and detection systems P&EFEx 1999 CD-ROM

SHTM 83 Fire safety in healthcare premises:general fire precautions

P&EFEx 1999 CD-ROM

SHTM 84 Fire safety in NHS residential careproperties

P&EFEx 1999 CD-ROM

SHTM 85 Fire precautions in existing hospitals P&EFEx 1999 CD-ROM

SHTM 86 Fire risk assessment in hospitals P&EFEx 1999 CD-ROM

SHTM 87 Textiles and furniture P&EFEx 1999 CD-ROM

SFPN 3 Escape bed lifts P&EFEx 1999 CD-ROM

SFPN 4 Hospital main kitchens P&EFEx 1999 CD-ROM

SFPN 5 Commercial enterprises on hospitalpremises

P&EFEx 1999 CD-ROM

SFPN 6 Arson prevention and control in NHShealthcare premises

P&EFEx 1999 CD-ROM

SFPN 7 Fire precautions in patient hotels P&EFEx 1999 CD-ROM

SFPN 10 Laboratories on hospital premises P&EFEx 1999 CD-ROM

UK Health Technical Guidance

CP 312 Code of practice for plastic pipework(thermoplastic material)

1973

EH 40 HSE Occupational Exposure limits HSE Annual

MES Model Engineering Specifications NHS Estates 1997 As required

Strategic guide to water and seweragepolicy for general managers and chiefexecutives

NHS Estates 1993

Chartered Institute of Building Service Engineers (CIBSE)

Environmental design; guide A CIBSE 1999

Installation and equipment data; guide B CIBSE 1986

Reference data; guide C CIBSE 2001 (expected)

Water distribution; commissioning codeseries W

CIBSE 1994

TM 13 Minimising the risk of Legionnaires’disease

CIBSE 2000

OOM Guide to ownership, operation andmaintenance of building services

CIBSE 2000

ARCHIVE




PublicationID


Miscellaneous References

Model Water Byelaws:Dept. of the Environment

HMSO 1986

The microbiology of water: part 1 HMSO 1994

Untapped savings: water services in theNHS

HMSO 1993

ISBN0117530107

The bacteriological examination of watersupplies: methods for the examination ofwaters and associated materials (Report71)

HMSO 1982

ISBN0901144347

Chemical disinfection in hospitals HMSO 1993 2nd edition

HS(G)70 The control of legionellosis includinglegionnaire’s disease

HMSO 1993

Pre-commission cleaning of watersystems

BSRIA 1991

TN 14/92 Decisions in maintenance BSRIA

AG 2/93 Hejab, M. Water treatment for buildingservices systems application guide

BSRIA 1993

AG 1/87 Armstrong, J. H. Operating andmaintenance manuals for buildingservices installations application guide

BSRIA 1990

AG 4/94 Guide to legionellosis – temperaturemeasurements for hot and cold waterservices

BSRIA

Water supply byelaws guide WaterResearchCentre

1989

Guidelines for drinking water quality:recommendations

WHO,HMSO

1993

Water fittings and materials directory WaterResearchCentre

Publishedevery 6months

Dadswell, J. V. Hygiene for hydrotherapypools

Public HealthLaboratoryService

1990

Water supplies and water consumption(engineering datasheet DY 1)

DHSS 1973

Water supplies: conservation(engineering datasheet DY 3)

DHSS 1973

The prevention or control of legionellosis(including legionnaires’ disease):approved code of practice

HMSO 1991

ARCHIVE




PublicationID


Standards for commercial spas:installation, chemical and watertreatment

SwimmingPool andAllied TradeAssociation

1989

Hygiene for hydrotherapy pools: report ofa working party on hygiene forhydrotherapy pools

HospitalInfectionResearchLaboratories

1986

ARCHIVE

Documents

SHTM 2027 Part 1 Ver2 - HFS Part 1 Ver2.pdfMemorandum 2027 (Part 1 of 4) Overview and management responsibilities Hot and cold water supply, storage and mains services NHSScotland,